FRANCISCAN CARE SERVICES INC: Form 990, tax year 2015

View the entire original 990 at ProPublica ↗

Organization: FRANCISCAN CARE SERVICES INC (EIN 47-0486026)
Tax period: 2015-01-01 to 2015-12-31
Filed: 2016-11-10
IRS object ID: 201603159349301770
Schema version: 2015v2.1
Source: Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header
Form 990
Schedule A
Schedule B
Schedule C
Schedule D
Schedule H
Schedule J
Schedule K
Schedule L
Schedule O
Schedule R

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2016-11-10T10:44:11-06:00	ReturnTs
Tax Period End	2015-12-31	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	KPMG LLP	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	1212 North 96th Street Suite 300	AddressLine1Txt
City	Omaha	CityNm
State Abbreviation	NE	StateAbbreviationCd
ZIP	68114	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2015-01-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	470486026	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	FRANCISCAN CARE SERVICES INC	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
In Care Of	% DENNIS DINSLAGE	InCareOfNm
Business Name Control	FRAN	BusinessNameControlTxt
Phone	4023722404	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	430 NORTH MONITOR STREET	AddressLine1Txt
City	WEST POINT	CityNm
State Abbreviation	NE	StateAbbreviationCd
ZIP	687881555	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	JERRY WORDEKEMPER	PersonNm
Person Title	President	PersonTitleTxt
Signature	2016-11-07	SignatureDt
Discuss With Paid Preparer	Yes (true)	DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	Lorraine A Egger	PreparerPersonNm
PTIN	P00223617	PTIN
Phone	4023481450	PhoneNum

Field	Value	IRS element (for citing)
Tax	2015	TaxYr
Build TS	2017-02-10 21:41:12Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Principal Officer	JERRY WORDEKEMPER	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	430 NORTH MONITOR STREET	AddressLine1Txt
City	WEST POINT	CityNm
State Abbreviation	NE	StateAbbreviationCd
ZIP	687881555	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$37,127,060	GrossReceiptsAmt
Group Return For Affiliates	false	GroupReturnForAffiliatesInd
Group Exemption	0928	GroupExemptionNum
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	www.fcswp.org	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1964	FormationYr
Legal Domicile State	NE	LegalDomicileStateCd
Activity Or Mission	THE MISSION OF FRANCISCAN CARE SERVICES INC. IS TO LIVE AND TO PROMOTE THE HEALING MISSION OF JESUS CHRIST.	ActivityOrMissionDesc
Voting Members Governing Body	12	VotingMembersGoverningBodyCnt
Voting Members Independent	7	VotingMembersIndependentCnt
Total Employee	307	TotalEmployeeCnt
Total Volunteers	288	TotalVolunteersCnt
Total Gross UBI	$10,156	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$9,156	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$394,122	PYContributionsGrantsAmt
CY Contributions Grants	$252,792	CYContributionsGrantsAmt
PY Program Service Revenue	$34,034,850	PYProgramServiceRevenueAmt
CY Program Service Revenue	$34,872,518	CYProgramServiceRevenueAmt
PY Investment Income	$1,494,877	PYInvestmentIncomeAmt
CY Investment Income	$1,939,603	CYInvestmentIncomeAmt
PY Other Revenue	$33,032	PYOtherRevenueAmt
CY Other Revenue	$17,180	CYOtherRevenueAmt
PY Total Revenue	$35,956,881	PYTotalRevenueAmt
CY Total Revenue	$37,082,093	CYTotalRevenueAmt
PY Grants And Similar Paid	$0	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$5,000	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$17,476,444	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$17,484,907	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$2,090	CYTotalFundraisingExpenseAmt
PY Other Expenses	$14,120,042	PYOtherExpensesAmt
CY Other Expenses	$13,662,192	CYOtherExpensesAmt
PY Total Expenses	$31,596,486	PYTotalExpensesAmt
CY Total Expenses	$31,152,099	CYTotalExpensesAmt
PY Revenues Less Expenses	$4,360,395	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$5,929,994	CYRevenuesLessExpensesAmt
Total Assets BOY	$66,324,457	TotalAssetsBOYAmt
Total Assets EOY	$68,733,058	TotalAssetsEOYAmt
Total Liabilities BOY	$17,073,655	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$15,709,832	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$49,250,802	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$53,023,226	NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part III	Yes (X)	InfoInScheduleOPartIIIInd
Mission	THE MISSION OF FRANCISCAN CARE SERVICES INC. IS TO LIVE AND TO PROMOTE THE HEALING MISSION OF JESUS CHRIST BY PROVIDING QUALITY HEALTH CARE AND HEALTH RELATED INPATIENT, OUTPATIENT, HOME HEALTH, PHYSICIAN AND ASSISTED LIVING SERVICES TO ANYONE IN NORTHEAST NEBRASKA, REGARDLESS OF THEIR ABILITY TO PAY.	MissionDesc
Significant New Program Srvc	false	SignificantNewProgramSrvcInd
Significant Change	false	SignificantChangeInd
Expense	$25,562,269	ExpenseAmt
Grant	$5,000	GrantAmt
Revenue	$32,868,723	RevenueAmt
Desc	FRANCISCAN CARE SERVICES MISSION IS TO PROVIDE QUALITY HEALTH CARE AND HEALTH RELATED INPATIENT, OUTPATIENT, HOME HEALTH AND PHYSICIAN SERVICES TO THE PEOPLE OF NORTHEASTERN NEBRASKA. THE CRITICAL ACCESS HOSPITAL PROVIDES A 24 HOUR EMERGENCY ROOM AND DOES NOT DISCRIMINATE AGAINST ANY PATIENT REGARDLESS OF THEIR ABILITY TO PAY. OUR CHARITY CARE POLICY FOLLOWS RECOMMENDED STANDARDS WHICH ARE BASED UPON THE FEDERAL POVERTY GUIDELINES. THIS POLICY IS COMMUNICATED TO OUR PATIENTS ON OUR WEBSITE AND AT OUR REGISTRATION DESKS. PATIENTS SERVED DURING THE YEAR: TOTAL MEDICARE MEDICAID IN-PATIENTS DISCHARGED 451 288 36 PATIENT DAYS - ACUTE 1,516 1,082 82 - SWING BED 1,287 976 NONE - NURSERY 109 NONE 38 OUT-PATIENT & HOME HEALTH 45,056 18,794 1,581 PHYSICIAN CLINIC VISITS 26,568 9,564 1,898 THE HOSPITAL RECEIVES GENEROUS SUPPORT FROM THE COMMUNITY NOT ONLY FINANCIALLY BUT ALSO FROM ABOUT 251 VOLUNTEERS WHO DONATED APPROXIMATELY 3,930 HOURS OF THEIR VALUABLE TIME.	Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

Field	Value	IRS element (for citing)
Expense	$1,849,345	ExpenseAmt
Grant	$0	GrantAmt
Revenue	$2,020,975	RevenueAmt
Desc	ASSISTED LIVING FACILITY FULFILLS THE MISSION OF THE ROMAN CATHOLIC CHURCH BY PROVIDING 78 FRAIL AND ELDERLY PEOPLE WITH ASSISTED LIVING SERVICES REGARDLESS OF THEIR ABILITY TO PAY. A TOTAL OF 18 RESIDENTS RECEIVED $212,667 IN FREE CARE DURING THE YEAR. APPROXIMATELY 37 VOLUNTEERS PROVIDED 4,215 HOURS OF SUPPORT TO THE FACILITY.	Desc

Field	Value	IRS element (for citing)
Total Program Service Expenses	$27,411,614	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (true)	DescribedInSection501c3Ind
Schedule B Required	Yes (true)	ScheduleBRequiredInd
Political Campaign Acty	false	PoliticalCampaignActyInd
Lobbying Activities	Yes (true)	LobbyingActivitiesInd
Subject To Proxy Tax	false	SubjectToProxyTaxInd
Donor Advised Fund	false	DonorAdvisedFundInd
Conservation Easements	false	ConservationEasementsInd
Collections Of Art	false	CollectionsOfArtInd
Credit Counseling	false	CreditCounselingInd
Temp Or Permanent Endowments	false	TempOrPermanentEndowmentsInd
Report Land Building Equipment	Yes (true)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	false	ReportInvestmentsOtherSecInd
Report Program Related Invst	false	ReportProgramRelatedInvstInd
Report Other Assets	false	ReportOtherAssetsInd
Report Other Liabilities	false	ReportOtherLiabilitiesInd
Include FIN48 Footnote	Yes (true)	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	Yes (true)	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	Yes (true)	ConsolidatedAuditFinclStmtInd
School Operating	false	SchoolOperatingInd
Foreign Office	false	ForeignOfficeInd
Foreign Activities	false	ForeignActivitiesInd
More Than5000 K To Org	false	MoreThan5000KToOrgInd
More Than5000 K To Individuals	false	MoreThan5000KToIndividualsInd
Professional Fundraising	false	ProfessionalFundraisingInd
Fundraising Activities	false	FundraisingActivitiesInd
Gaming Activities	false	GamingActivitiesInd
Operate Hospital	Yes (true)	OperateHospitalInd
Audited Financial Stmt Att	Yes (true)	AuditedFinancialStmtAttInd
Grants To Organizations	false	GrantsToOrganizationsInd
Grants To Individuals	false	GrantsToIndividualsInd
Schedule J Required	Yes (true)	ScheduleJRequiredInd
Tax Exempt Bonds	Yes (true)	TaxExemptBondsInd
Invest Tax Exempt Bonds	false	InvestTaxExemptBondsInd
Escrow Account	false	EscrowAccountInd
On Behalf Of Issuer	false	OnBehalfOfIssuerInd
Engaged In Excess Benefit Trans	false	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	false	PYExcessBenefitTransInd
Loan Outstanding	false	LoanOutstandingInd
Grant To Related Person	false	GrantToRelatedPersonInd
Business Rln With Org Mem	false	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	Yes (true)	BusinessRlnWithFamMemInd
Business Rln With Officer Ent	false	BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri	false	DeductibleNonCashContriInd
Deductible Art Contribution	false	DeductibleArtContributionInd
Terminate Operations	false	TerminateOperationsInd
Partial Liquidation	false	PartialLiquidationInd
Disregarded Entity	false	DisregardedEntityInd
Related Entity	Yes (true)	RelatedEntityInd
Related Organization Ctrl Ent	false	RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	false	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	false	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (true)	ScheduleORequiredInd
IRP Document	64	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (true)	BackupWthldComplianceInd
Employee	307	EmployeeCnt
Employment Tax Returns Filed	Yes (true)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	Yes (true)	UnrelatedBusIncmOverLimitInd
Form990 T Filed	Yes (true)	Form990TFiledInd
Foreign Financial Account	false	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTransInd
Taxable Party Notification	false	TaxablePartyNotificationInd
Nondeductible Contributions	false	NondeductibleContributionsInd
Quid Pro Quo Contributions	false	QuidProQuoContributionsInd
Form8282 Property Disposed Of	false	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	false	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	false	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	false	IndoorTanningServicesInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	12	GoverningBodyVotingMembersCnt
Independent Voting Member	7	IndependentVotingMemberCnt
Family Or Business Rln	Yes (true)	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	false	DelegationOfMgmtDutiesInd
Change To Org Documents	false	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	false	MaterialDiversionOrMisuseInd
Members Or Stockholders	Yes (true)	MembersOrStockholdersInd
Election Of Board Members	Yes (true)	ElectionOfBoardMembersInd
Decisions Subject To Approva	Yes (true)	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (true)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (true)	MinutesOfCommitteesInd
Officer Mailing Address	false	OfficerMailingAddressInd
Local Chapters	false	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (true)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (true)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (true)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (true)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (true)	WhistleblowerPolicyInd
Document Retention Policy	Yes (true)	DocumentRetentionPolicyInd
Compensation Process CEO	Yes (true)	CompensationProcessCEOInd
Compensation Process Other	false	CompensationProcessOtherInd
Investment In Joint Venture	false	InvestmentInJointVentureInd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Field	Value	IRS element (for citing)
Person	DENNIS DINSLAGE	PersonNm
Phone	4023726703	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	430 NORTH MONITOR STREET	AddressLine1Txt
City	WEST POINT	CityNm
State Abbreviation	NE	StateAbbreviationCd
ZIP	687881555	ZIPCd

Field	Value	IRS element (for citing)
Info In Schedule O Part VII	Yes (X)	InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (21 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	OfficerOfficerInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	Key EmployeeKeyEmployeeInd	Highest Compensated EmployeeHighestCompensatedEmployeeInd
Jerry Wordekemper
CEO & Trustee	45.0	0.35	Yes (X)	Yes (X)	$147,517	$0	$32,590
Ronald O Briggs
CEO & Trustee	45.0	0.35	Yes (X)	Yes (X)	$208,339	$0	$17,073
Bill Kreikemeier
Chairman	1.5	0.0	Yes (X)	Yes (X)	$0	$0	$0
Jerome Steffen
Vice Chairman	1.5	0.25	Yes (X)	Yes (X)	$0	$0	$0
Jackie Ridder
Secretary	1.5	0.0	Yes (X)	Yes (X)	$0	$0	$0
Steve Ausdemore
Treasurer	1.5	0.0	Yes (X)	Yes (X)	$0	$0	$0
Chad Ortmeier DDS
Trustee	1.0	0.25	Yes (X)		$0	$0	$0
Mary Janata
Trustee	1.0	0.0	Yes (X)		$0	$0	$0
Garry Clark
Trustee	1.0	0.0	Yes (X)		$0	$0	$0
Gary Kaup
Trustee	1.0	0.0	Yes (X)		$0	$0	$0
Dave Steffensmeier
Trustee	1.0	0.0	Yes (X)		$0	$0	$0
Steve Swanson
Trustee	1.0	0.0	Yes (X)		$0	$0	$0
Sr Doris Jurgenson
Trustee	1.0	0.0	Yes (X)		$0	$0	$0
Sr Sarah Bertler
Trustee	1.0	0.0	Yes (X)		$0	$0	$0
Dennis Dinslage
V.P. Fiscal & Support Services	42.0	0.0		Yes (X)	$166,089	$0	$34,994
Terry Nelson
Rehab Manager	55.0	0.0			$193,459	$0	$42,548	Yes (X)
Kenneth Pitz MD
Physician	40.0	0.0			$491,203	$0	$41,169		Yes (X)
Michael Bittles MD
Physician	40.0	0.0			$415,362	$0	$41,704		Yes (X)
Scott Green MD
Physician	44.6	0.0			$410,103	$0	$43,169		Yes (X)
Brian Hass MD
Physician	42.5	0.0			$382,784	$0	$40,966		Yes (X)
Rhett Eckmann MD
Physician	42.79	0.0			$358,417	$0	$40,966		Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$2,773,273	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$0	TotReportableCompRltdOrgAmt
Total Other Compensation	$335,179	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	19	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	false	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (true)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	false	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1Txt	CityContractorAddress/USAddress/CityNm	State AbbreviationContractorAddress/USAddress/StateAbbreviationCd	ZIPContractorAddress/USAddress/ZIPCd	ServicesServicesDesc	CompensationCompensationAmt
KAT ANESTHESIA LLC
606 VISTA AVENUE	WEST POINT	NE	68788	ANESTHESIA SERVICES	$601,040
CYPRESS BENEFIT ADMINISTRATOR
PO BOX 7020	APPLETON	WI	549127020	HEALTH PLAN ADMIN	$500,377
IP PATHWAYS LLC
2550 73RD STREET	URBANDALE	IA	50322	IT SOFTWARE SUPPORT	$314,443
Prairie Health Ventures
290 The Apothecary 140 N 8th St	LINCOLN	NE	68508	IT DATA SUPPORT	$305,073
MCKESSON TECHNOLOGIES INC
5995 WINDWARD PARKWAY	ALPHARETTA	GA	30005	IT SOFTWARE SUPPORT	$269,856

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	8	CntrctRcvdGreaterThan100KCnt
Related Organizations	$213,945	RelatedOrganizationsAmt
All Other Contributions	$38,847	AllOtherContributionsAmt
Total Contributions	$252,792	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
HOSPITAL/CLINIC HEALTHCARE SERVICES	621110	$32,800,310	$32,800,310
ASSISTED LIVING-ELDER CARE	623000	$1,972,380	$1,972,380
DIETARY/CAFETERIA	721000	$99,828	$99,828

Field	Value	IRS element (for citing)
Total Program Service Revenue	$34,872,518	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$1,929,314	TotalRevenueColumnAmt
Unrelated Business Revenue	$10,156	UnrelatedBusinessRevenueAmt
Exclusion	$1,919,158	ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	$0	RealAmt
Personal	$0	PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Other	$35,802	OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Other	$25,513	OtherAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Other	$10,289	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$10,289	TotalRevenueColumnAmt
Exclusion	$10,289	ExclusionAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Net Income From Gaming NetIncomeFromGamingGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Field	Value	IRS element (for citing)
Gross Sales Of Inventory	$36,634	GrossSalesOfInventoryAmt
Cost Of Goods Sold	$19,454	CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$17,180	TotalRevenueColumnAmt
Related Or Exempt Func Income	$17,180	RelatedOrExemptFuncIncomeAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$0	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$37,082,093	TotalRevenueColumnAmt
Related Or Exempt Func Income	$34,889,698	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$10,156	UnrelatedBusinessRevenueAmt
Exclusion	$1,929,447	ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$5,000	TotalAmt
Program Services	$5,000	ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Foreign Grants ForeignGrantsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Benefits To Members BenefitsToMembersGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$847,179	TotalAmt
Program Services	$731,327	ProgramServicesAmt
Management And General	$115,852	ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$13,606,160	TotalAmt
Program Services	$12,281,705	ProgramServicesAmt
Management And General	$1,324,455	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$380,993	TotalAmt
Program Services	$305,455	ProgramServicesAmt
Management And General	$75,538	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$1,778,484	TotalAmt
Program Services	$1,445,123	ProgramServicesAmt
Management And General	$333,361	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$872,091	TotalAmt
Program Services	$774,767	ProgramServicesAmt
Management And General	$97,324	ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$10,084	TotalAmt
Management And General	$10,084	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$91,914	TotalAmt
Management And General	$91,914	ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

Field	Value	IRS element (for citing)
Total	$3,297	TotalAmt
Management And General	$3,297	ManagementAndGeneralAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$2,816,898	TotalAmt
Program Services	$2,447,262	ProgramServicesAmt
Management And General	$369,636	ManagementAndGeneralAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$137,098	TotalAmt
Program Services	$135,655	ProgramServicesAmt
Management And General	$1,443	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$1,497,074	TotalAmt
Program Services	$1,344,450	ProgramServicesAmt
Management And General	$152,624	ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$712,916	TotalAmt
Program Services	$577,436	ProgramServicesAmt
Management And General	$135,480	ManagementAndGeneralAmt

Royalties RoyaltiesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$1,196,599	TotalAmt
Program Services	$1,025,282	ProgramServicesAmt
Management And General	$171,317	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$124,213	TotalAmt
Program Services	$104,932	ProgramServicesAmt
Management And General	$19,281	ManagementAndGeneralAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$101,160	TotalAmt
Program Services	$95,928	ProgramServicesAmt
Management And General	$5,232	ManagementAndGeneralAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Payments To Affiliates PaymentsToAffiliatesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$3,899,941	TotalAmt
Program Services	$3,158,812	ProgramServicesAmt
Management And General	$741,129	ManagementAndGeneralAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$68,298	TotalAmt
Management And General	$68,298	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt	FundraisingFundraisingAmt
MEDICAL SUPPLIES	$2,865,784	$2,865,784
DUES & SUBSCRIPTIONS	$133,708	$112,696	$21,012
WOMEN'S AUXILIARY SUPPLIES	$2,090			$2,090
UNRELATED BUSINESS INCOME TAXE	$1,118		$1,118

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$31,152,099	TotalAmt
Program Services	$27,411,614	ProgramServicesAmt
Management And General	$3,738,395	ManagementAndGeneralAmt
Fundraising	$2,090	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$847,529	BOYAmt
EOY	$872,518	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$7,779,255	BOYAmt
EOY	$12,249,756	EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$4,267,858	BOYAmt
EOY	$4,719,283	EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

Field	Value	IRS element (for citing)
BOY	$20,000	BOYAmt
EOY	$0	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$561,443	BOYAmt
EOY	$655,855	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$156,350	BOYAmt
EOY	$220,214	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$59,962,819	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$31,787,610	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$30,337,825	BOYAmt
EOY	$28,175,209	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$19,337,390	BOYAmt
EOY	$19,439,232	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$1,795,562	BOYAmt
EOY	$1,379,934	EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Intangible Assets IntangibleAssetsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$1,221,245	BOYAmt
EOY	$1,021,057	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$66,324,457	BOYAmt
EOY	$68,733,058	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$4,892,701	BOYAmt
EOY	$4,609,107	EOYAmt

Grants Payable GrantsPayableGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Deferred Revenue DeferredRevenueGrp

Field	Value	IRS element (for citing)
BOY	$1,187,379	BOYAmt
EOY	$540,464	EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$10,993,575	BOYAmt
EOY	$10,560,261	EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$17,073,655	BOYAmt
EOY	$15,709,832	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows SFAS117	Yes (X)	OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$49,250,802	BOYAmt
EOY	$53,023,226	EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$49,250,802	BOYAmt
EOY	$53,023,226	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$66,324,457	BOYAmt
EOY	$68,733,058	EOYAmt

Field	Value	IRS element (for citing)
Reconcilation Revenue Expnss	$5,929,994	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	-$2,157,570	NetUnrlzdGainsLossesInvstAmt
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	false	AccountantCompileOrReviewInd
FS Audited	Yes (true)	FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

Field	Value	IRS element (for citing)
Consol And Sep Basis Fincl Stmt	Yes (X)	ConsolAndSepBasisFinclStmtInd

Field	Value	IRS element (for citing)
Audit Committee	Yes (true)	AuditCommitteeInd
Federal Grant Audit Required	false	FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital	Yes (X)	HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

Field	Value	IRS element (for citing)
Contributor	RESTRICTED	ContributorNum

Contributor Business Name ContributorBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor US Address ContributorUSAddress

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Total Contributions	RESTRICTED	TotalContributionsAmt

Schedule C IRS990ScheduleC

Field	Value	IRS element (for citing)
Total Grassroots Lobbying		TotalGrassrootsLobbyingGrp
Total Direct Lobbying		TotalDirectLobbyingGrp
Total Lobbying Expend		TotalLobbyingExpendGrp
Other Exempt Purpose Expend		OtherExemptPurposeExpendGrp
Total Exempt Purpose Expend		TotalExemptPurposeExpendGrp
Lobbying Nontaxable Amount		LobbyingNontaxableAmountGrp
Grassroots Nontaxable		GrassrootsNontaxableGrp
Tot Lbbyng Grassroot Mns Non Tx		TotLbbyngGrassrootMnsNonTxGrp
Tot Lbby Expend Mns Lbbyng Non Tx		TotLbbyExpendMnsLbbyngNonTxGrp
Volunteers	false	VolunteersInd
Paid Staff Or Management	false	PaidStaffOrManagementInd
Media Advertisements	false	MediaAdvertisementsInd
Mailings Members	false	MailingsMembersInd
Publications Or Broadcast	false	PublicationsOrBroadcastInd
Grants Other Organizations	Yes (true)	GrantsOtherOrganizationsInd
Grants Other Organizations	$3,297	GrantsOtherOrganizationsAmt
Direct Contact Legislators	Yes (true)	DirectContactLegislatorsInd
Direct Contact Legislators	$0	DirectContactLegislatorsAmt
Rallies Demonstrations	false	RalliesDemonstrationsInd
Other Activities	false	OtherActivitiesInd
Total Lobbying Expenditures	$3,297	TotalLobbyingExpendituresAmt
Not Described Section501c3	false	NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
SCHEDULE C, PART II-B, LINE F	MEMBERSHIP DUES PAID TO HEALTH CARE ASSOCIATIONS OF WHICH A PERCENTAGE OF THE DUES ARE ALLOCATED TO LOBBYING ACTIVITIES.
SCHEDULE C, PART II-B, LINE G	OCCASIONAL PHONE CALL OR EMAIL TO AND FROM OUR REPRESENTATIVES.

Schedule D IRS990ScheduleD

Field	Value	IRS element (for citing)
Art Public Exhibition Amounts		ArtPublicExhibitionAmountsGrp
Held Works Art		HeldWorksArtGrp
CY Minus3 Yr Endwmt Fund		CYMinus3YrEndwmtFundGrp
CY Minus4 Yr Endwmt Fund		CYMinus4YrEndwmtFundGrp

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$508,681	OtherCostOrOtherBasisAmt
Book Value	$508,681	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$21,584,295	OtherCostOrOtherBasisAmt
Depreciation	$9,128,859	DepreciationAmt
Book Value	$12,455,436	BookValueAmt

Field	Value	IRS element (for citing)
Leasehold Improvements		LeaseholdImprovementsGrp

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$37,702,153	OtherCostOrOtherBasisAmt
Depreciation	$22,658,751	DepreciationAmt
Book Value	$15,043,402	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$167,690	OtherCostOrOtherBasisAmt
Depreciation	$0	DepreciationAmt
Book Value	$167,690	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$28,175,209	TotalBookValueLandBuildingsAmt
Federal Income Tax Liability	$0	FederalIncomeTaxLiabilityAmt
Total Liability	$0	TotalLiabilityAmt
Footnote Text	Yes (X)	FootnoteTextInd
Total Rev Etc Audited Fincl Stmt	$34,933,624	TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst	-$2,157,570	NetUnrealizedGainsInvstAmt
Revenue Not Reported	-$2,157,570	RevenueNotReportedAmt
Revenue Subtotal	$37,091,194	RevenueSubtotalAmt
Other Revenues Not Included	-$9,101	OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt	-$9,101	RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990	$37,082,093	TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt	$31,150,009	TotExpnsEtcAuditedFinclStmtAmt
Expenses Subtotal	$31,150,009	ExpensesSubtotalAmt
Other Expenses Not Included	$2,090	OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt	$2,090	ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990	$31,152,099	TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
SCHEDULE D, PART XI, LINE 4B	AUXILIARY GIFT SHOP SALES 24,248 AUXILIARY GIFT SHOP COGS (19,454) --------- NET GAIN FROM SALES 4,794 AUXILIARY FUNDS RAISED 5,469 AUXILIARY DONATION TO HOSPITAL (19,364) --------- TOTAL (9,101)
SCHEDULE D, PART XII, LINE 4B	AUXILIARY OPERATING EXPENSES 2,090
SCHEDULE D, PART X, LINE 2	FIN 48 FOOTNOTE ON AUDITED FINANCIAL STATEMENTS: The organization has evaluated and reviewed uncertain tax positions and found the potential exposure to be insignificant.

Schedule H IRS990ScheduleH

Field	Value	IRS element (for citing)
Financial Assistance Policy	Yes (true)	FinancialAssistancePolicyInd
Written Policy	Yes (true)	WrittenPolicyInd
All Hospitals Policy	Yes (X)	AllHospitalsPolicyInd
FPG Reference Free Care	Yes (true)	FPGReferenceFreeCareInd
Percent100	Yes (X)	Percent100Ind
FPG Reference Discounted Care	Yes (true)	FPGReferenceDiscountedCareInd
Percent200 D	Yes (X)	Percent200DInd
Free Care Medically Indigent	Yes (true)	FreeCareMedicallyIndigentInd
Financial Assistance Budget	Yes (true)	FinancialAssistanceBudgetInd
Expenses Exceed Budget	false	ExpensesExceedBudgetInd
Annual Community Bnft Report	Yes (true)	AnnualCommunityBnftReportInd
Report Publically Available	Yes (true)	ReportPublicallyAvailableInd

Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp

Field	Value	IRS element (for citing)
Persons Served	364	PersonsServedCnt
Total Community Benefit Expns	$355,407	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$355,407	NetCommunityBenefitExpnsAmt
Total Expense	0.01140	TotalExpensePct

Unreimbursed Medicaid UnreimbursedMedicaidGrp

Field	Value	IRS element (for citing)
Persons Served	4239	PersonsServedCnt
Total Community Benefit Expns	$1,604,330	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$1,388,016	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$216,314	NetCommunityBenefitExpnsAmt
Total Expense	0.00690	TotalExpensePct

Unreimbursed Costs UnreimbursedCostsGrp

Field	Value	IRS element (for citing)
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$0	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.00000	TotalExpensePct

Total Financial Assistance Typ TotalFinancialAssistanceTyp

Field	Value	IRS element (for citing)
Persons Served	4603	PersonsServedCnt
Total Community Benefit Expns	$1,959,737	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$1,388,016	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$571,721	NetCommunityBenefitExpnsAmt
Total Expense	0.01830	TotalExpensePct

Community Health Services CommunityHealthServicesGrp

Field	Value	IRS element (for citing)
Persons Served	2534	PersonsServedCnt
Total Community Benefit Expns	$196,007	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$28,429	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$167,578	NetCommunityBenefitExpnsAmt
Total Expense	0.00540	TotalExpensePct

Health Professions Education HealthProfessionsEducationGrp

Field	Value	IRS element (for citing)
Persons Served	152	PersonsServedCnt
Total Community Benefit Expns	$106,450	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$106,450	NetCommunityBenefitExpnsAmt
Total Expense	0.00340	TotalExpensePct

Subsidized Health Services SubsidizedHealthServicesGrp

Field	Value	IRS element (for citing)
Persons Served	22771	PersonsServedCnt
Total Community Benefit Expns	$5,701,821	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$4,883,989	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$817,832	NetCommunityBenefitExpnsAmt
Total Expense	0.02620	TotalExpensePct

Research ResearchGrp

Field	Value	IRS element (for citing)
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$0	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.00000	TotalExpensePct

Cash And In Kind Contributions CashAndInKindContributionsGrp

Field	Value	IRS element (for citing)
Persons Served	0	PersonsServedCnt
Total Community Benefit Expns	$0	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$0	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$0	NetCommunityBenefitExpnsAmt
Total Expense	0.00000	TotalExpensePct

Total Other Benefits TotalOtherBenefitsGrp

Field	Value	IRS element (for citing)
Persons Served	25457	PersonsServedCnt
Total Community Benefit Expns	$6,004,278	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$4,912,418	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,091,860	NetCommunityBenefitExpnsAmt
Total Expense	0.03500	TotalExpensePct

Total Community Benefits TotalCommunityBenefitsGrp

Field	Value	IRS element (for citing)
Persons Served	30060	PersonsServedCnt
Total Community Benefit Expns	$7,964,015	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$6,300,434	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$1,663,581	NetCommunityBenefitExpnsAmt
Total Expense	0.05330	TotalExpensePct

Economic Development EconomicDevelopmentGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$8,401	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$8,401	NetCommunityBenefitExpnsAmt
Total Expense	0.00030	TotalExpensePct

Community Support CommunitySupportGrp

Field	Value	IRS element (for citing)
Persons Served	6388	PersonsServedCnt
Total Community Benefit Expns	$48,253	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$2,170	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$46,083	NetCommunityBenefitExpnsAmt
Total Expense	0.00150	TotalExpensePct

Workforce Development WorkforceDevelopmentGrp

Field	Value	IRS element (for citing)
Total Community Benefit Expns	$1,500	TotalCommunityBenefitExpnsAmt
Net Community Benefit Expns	$1,500	NetCommunityBenefitExpnsAmt
Total Expense	0.00000	TotalExpensePct

Total Communtity Building Acty TotalCommuntityBuildingActyGrp

Field	Value	IRS element (for citing)
Persons Served	6388	PersonsServedCnt
Total Community Benefit Expns	$58,154	TotalCommunityBenefitExpnsAmt
Direct Offsetting Revenue	$2,170	DirectOffsettingRevenueAmt
Net Community Benefit Expns	$55,984	NetCommunityBenefitExpnsAmt
Total Expense	0.00180	TotalExpensePct

Field	Value	IRS element (for citing)
Bad Debt Expense Reported	Yes (true)	BadDebtExpenseReportedInd
Bad Debt Expense	$754,244	BadDebtExpenseAmt
Bad Debt Expense Attributable	$150,848	BadDebtExpenseAttributableAmt
Reimbursed By Medicare	$10,900,682	ReimbursedByMedicareAmt
Cost Of Care Reimbursed By Medcr	$11,188,342	CostOfCareReimbursedByMedcrAmt
Medicare Surplus Or Shortfall	-$287,660	MedicareSurplusOrShortfallAmt

Costing Methodology Used CostingMethodologyUsedGrp

Field	Value	IRS element (for citing)
Cost To Charge Ratio	Yes (X)	CostToChargeRatioInd

Field	Value	IRS element (for citing)
Written Debt Collection Policy	Yes (true)	WrittenDebtCollectionPolicyInd
Financial Assistance Prvsn	Yes (true)	FinancialAssistancePrvsnInd
Hospital Facilities	1	HospitalFacilitiesCnt

Hospital Facilities HospitalFacilitiesGrp

Field	Value	IRS element (for citing)
Facility	1	FacilityNum

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	ST FRANCIS MEMORIAL HOSPITAL	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	430 N MONITOR ST	AddressLine1Txt
City	WEST POINT	CityNm
State Abbreviation	NE	StateAbbreviationCd
ZIP	68788	ZIPCd

Field	Value	IRS element (for citing)
Website Address	www.fcswp.org	WebsiteAddressTxt
State License	NE LIC #180001	StateLicenseNum
Licensed Hospital	Yes (X)	LicensedHospitalInd
General Medical And Surgical	Yes (X)	GeneralMedicalAndSurgicalInd
Critical Access Hospital	Yes (X)	CriticalAccessHospitalInd
Emergency Room24 Hrs	Yes (X)	EmergencyRoom24HrsInd

Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp

Hospital Facility Name HospitalFacilityName

Field	Value	IRS element (for citing)
Business Name Line1	ST FRANCIS MEMORIAL HOSPITAL	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Facility	1	FacilityNum
First Licensed CY Or PY	false	FirstLicensedCYOrPYInd
Tax Exempt Hospital CY Or PY	false	TaxExemptHospitalCYOrPYInd
CHNA Conducted	Yes (true)	CHNAConductedInd
Community Definition	Yes (X)	CommunityDefinitionInd
Community Demographics	Yes (X)	CommunityDemographicsInd
Existing Resources	Yes (X)	ExistingResourcesInd
How Data Obtained	Yes (X)	HowDataObtainedInd
Community Health Needs	Yes (X)	CommunityHealthNeedsInd
Other Health Issues	Yes (X)	OtherHealthIssuesInd
Community Hlth Needs Id Process	Yes (X)	CommunityHlthNeedsIdProcessInd
Consulting Process	Yes (X)	ConsultingProcessInd
CHNA Conducted	13	CHNAConductedYr
Take Into Account Others Input	Yes (true)	TakeIntoAccountOthersInputInd
CHNA Conducted With Other Fclts	Yes (true)	CHNAConductedWithOtherFcltsInd
CHNA Conducted With Non Fclts	Yes (true)	CHNAConductedWithNonFcltsInd
CHNA Report Widely Available	Yes (true)	CHNAReportWidelyAvailableInd
Rpt Available On Own Website	Yes (X)	RptAvailableOnOwnWebsiteInd
Own Website URL	SEE PART V, SECTION C	OwnWebsiteURLTxt
Paper Copy Public Inspection	Yes (X)	PaperCopyPublicInspectionInd
Implementation Strategy Adopt	Yes (true)	ImplementationStrategyAdoptInd
Implementation Strategy Adpt	13	ImplementationStrategyAdptYr
Strategy Posted Website	Yes (true)	StrategyPostedWebsiteInd
Strategy Website URL	SEE PART V, SECTION C	StrategyWebsiteURLTxt
Strategy Attached	false	StrategyAttachedInd
Organization Incur Excise Tax	false	OrganizationIncurExciseTaxInd
Elig Criteria Explained	Yes (true)	EligCriteriaExplainedInd
FPG Family Incm Lmt Free Dscnt	Yes (X)	FPGFamilyIncmLmtFreeDscntInd
FPG Family Incm Lmt Free Care	100	FPGFamilyIncmLmtFreeCarePct
FPG Family Incm Lmt Dscnt Care	200.	FPGFamilyIncmLmtDscntCarePct
Asset Level Criteria	Yes (X)	AssetLevelCriteriaInd
Medical Indigency Criteria	Yes (X)	MedicalIndigencyCriteriaInd
Other Criteria	Yes (X)	OtherCriteriaInd
Explained Basis	Yes (true)	ExplainedBasisInd
App Financial Asst Expln	Yes (true)	AppFinancialAsstExplnInd
Described Info	Yes (X)	DescribedInfoInd
Described Suprt Doc	Yes (X)	DescribedSuprtDocInd
Includes Publicity Measures	Yes (true)	IncludesPublicityMeasuresInd
FAP Summary On Website	Yes (X)	FAPSummaryOnWebsiteInd
FAP Summary On Website URL	SEE PART V, SECTION C	FAPSummaryOnWebsiteURLTxt
FAP Avlbl On Request No Charge	Yes (X)	FAPAvlblOnRequestNoChargeInd
FAP App Avlbl On Request No Chrg	Yes (X)	FAPAppAvlblOnRequestNoChrgInd
FAP Notice Displayed	Yes (X)	FAPNoticeDisplayedInd
Other Publicity	Yes (X)	OtherPublicityInd
FAP Actions On Nonpayment	Yes (true)	FAPActionsOnNonpaymentInd
Permit No Actions	Yes (X)	PermitNoActionsInd
Collection Activities	false	CollectionActivitiesInd
FAP Notified All Patients	Yes (X)	FAPNotifiedAllPatientsInd
Documented Elig Determination	Yes (X)	DocumentedEligDeterminationInd
Nondis Emergency Care Policy	Yes (true)	NondisEmergencyCarePolicyInd
Average Negotiated Rates	Yes (X)	AverageNegotiatedRatesInd
Amounts Generally Billed	false	AmountsGenerallyBilledInd
Gross Charges	false	GrossChargesInd

Supplemental Information SupplementalInformationGrp (10 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
SCHEDULE H, PART V, SECTION B, LINE 5	Input from diverse sectors involved in public health was obtained through key informant interviews from the followings groups: state senators/city/county elected officials, hospital administrators, allied health programs, licensed medical practitioners, behavioral health executives, emergency response planners, community-based organizations, family planning director, community college administrators, healthcare students, health education directors, community health center executives, minority community leaders, business leaders, and school administrators. Opinions and insight from minority groups were sought as part of the process by conducting door-to-door surveys of Hispanic households in West Point, Stanton, Norfolk, and Madison, Nebraska. Data was also collected through community-level health surveys administered on-line and through regular mail. This was accomplished by distributing postcards inviting participation in the community-level survey to every postal patron (approximately 23,000 households) in the Elkhorn Logan Valley Public Health Department jurisdiction on two separate occasions. Lastly, a Community Health Improvement Plan Stakeholder/Focus Group was held in West Point, Nebraska and Norfolk, Nebraska. Approximately 275 invitations were sent out to key stakeholders in the public health system. There were 39 individuals that attended the Focus Group meeting in West Point, and 36 individuals attended the Focus Group meeting in Norfolk. Meeting participants include members of the Hispanic community, elected officials, hospitals and health care professionals, dental advocates, agencies serving the elderly, citizens at large, behavioral health, mental health, business/industries, schools, churches and other religious affiliates, not-for-profit agencies, youth and family serving organizations, law enforcement, tribal representatives, and prevention community organizers.
SCHEDULE H, PART V, SECTION B, LINE 6a	ST. FRANCIS MEMORIAL HOSPITAL CONDUCTED ITS CHNA IN CONJUNCTION WITH OAKLAND MERCY HOSPITAL IN OAKLAND, NEBRASKA AND FAITH REGIONAL HEALTH SERVICES IN NORFOLK, NEBRASKA.
SCHEDULE H, PART V, SECTION B, LINE 6b	ST. FRANCIS MEMORIAL HOSPITAL CONDUCTED ITS CHNA IN CONJUNCTION WITH ELKHORN LOGAN VALLEY PUBLIC HEALTH DEPARTMENT.
SCHEDULE H, PART V, SECTION B, LINE 7a	THE CHNA FOR ST. FRANCIS MEMORIAL HOSPITAL IS AVAILABLE AT: HTTP://WORDPRESS.fcswp.org/community-health-needs-assessment/.
SCHEDULE H, PART V, SECTION B, LINE 10A	ST. FRANCIS MEMORIAL HOSPITAL'S CHNA IMPLEMENTATION STRATEGY IS AVAILABLE AT: HTTP://WORDPRESS.FCSWP.ORG/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/.
SCHEDULE H, PART V, SECTION B, LINE 11	THE CHNA REVEALED FOUR MAIN HEALTH PRIORITIES IN OUR AREA: 1) OBESITY 2) BEHAVIORAL/MENTAL HEALTH, 3) PREVENTION, AND 4) RISKY BEHAVIORS. SEVERAL OVERALL GOALS WERE ESTABLISHED BASED ON THE PRECEDING HEALTH PRIORITIES. THESE GOALS ARE: 1) ENHANCE ACCESS TO CARE, 2) CREATE OPPORTUNITIES FOR COMMUNITY ORGANIZATIONS TO PROVIDE AND PARTICIPATE IN ACTIVITIES THAT PROMOTE HEALTHY LIFESTYLES, 3) RAISE COMMUNITY LEVEL OF AWARENESS REGARDING PUBLIC HEALTH ISSUES, 4) EXPAND SAFETY PROGRAMMING AND INFORMATION OFFERED TO THE PUBLIC, AND 5) HELP THE PUBLIC BECOME MORE INFORMED ABOUT WHAT PUBLIC HEALTH IS AND WHAT SERVICES ARE AVAILABLE IN THIS AREA. WE HAVE DETAILED THE ACTIONS THAT WERE TAKEN IN 2015 TO RESPOND TO THE ISSUES IDENTIFIED IN THE CHNA ON OUR WEBSITE AT HTTP://WORDPRESS.FCSWP.ORG/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/.
SCHEDULE H, PART V, SECTION B, LINE 13H	OTHER FACTORS USED IN DETERMINING ELIGIBILITY FOR FINANCIAL ASSISTANCE INCLUDE ELIGIBILITY FOR MEDICAID, SOCIAL SECURITY OR A BANK LOAN.
SCHEDULE H, PART V, SECTION B, LINE 14	ACCORDING TO THE PATIENT PROTECTION AND AFFORDABLE CARE ACT OF 2010 (PPACA) AMOUNTS CHARGED FOR MEDICALLY NECESSARY CARE TO INDIVIDUALS ELIGIBLE UNDER THE FINANCIAL ASSISTANCE POLICY CANNOT EXCEED THE LOWEST AMOUNT BILLED TO THOSE WITH INSURANCE. THEREFORE, AS OF JANUARY 1, 2011, INDIVIDUALS QUALIFYING FOR THE CHARITY CARE PROGRAM WILL AUTOMATICALLY RECEIVE A 4% DISCOUNT BEFORE APPLYING THE CHARITABLE DISCOUNT ANNUAL INCOME GUIDELINES. THE 4% DISCOUNT IS OUR LOWEST NEGOTIATED COMMERCIAL RATE. THE 4% DISCOUNT WILL BE WRITTEN OFF AS A CHARITY CARE ADJUSTMENT.
SCHEDULE H, PART V, SECTION B, LINE 16C	A PLAIN LANGUAGE SUMMARY OF THE FAP IS AVAILABLE AT HTTP://WWW.FCSWP.ORG/CHARITY-CARE/.
SCHEDULE H, PART V, SECTION B, LINE 16I	A PLAIN LANGUAGE SUMMARY OF THE FINANCIAL ASSISTANCE POLICY IS INCLUDED WITH THE BILLING STATEMENT AFTER CONTACT HAS BEEN MADE BY THE FINANCIAL COUNSELOR. ALSO, EMPLOYEES MAY REFER PATIENTS WHO ARE UNINSURED OR UNDERINSURED TO THE FINANCIAL COUNSELOR.

Field	Value	IRS element (for citing)
Facility	1	FacilityNum

Oth Hlth Care Fclts Not Hospital OthHlthCareFcltsNotHospitalGrp

Oth Hlth Care Fclts OthHlthCareFcltsGrp

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	ST JOSEPH'S RETIREMENT COMMUNITY	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	320 E DECATUR ST	AddressLine1Txt
City	WEST POINT	CityNm
State Abbreviation	NE	StateAbbreviationCd
ZIP	68788	ZIPCd

Field	Value	IRS element (for citing)
Facility	ASSISTED LIVING FACILITY	FacilityTxt

Supplemental Information Detail SupplementalInformationDetail (15 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Schedule H, Part I, Line 7	A cost-to-charge ratio was used to calculate the cost of community benefit expenses detailed in the table for Part I, line 7(a) 7(k). The cost-to-charge ratio was derived from Worksheet 2, Ratio of Patient Care Cost-to-Charges.
Schedule H, Part I, Line 7, Column F	The amount used to compute column (f) is from the amount reported on Form 990, Part IX, line 25, column (a).
Schedule H, Part I, Line 7G	Subsidized health services of $817,832 are reported on line 7g. Of this amount, $812,264 represents the community benefit attributable to physician services.
Schedule H, Part II	Franciscan Care Services, Inc. currently has involvement in the Elkhorn Logan Valley Public Health Department Board which looks at how the community addresses health and safety issues, the access individuals have to health care services, and the staff necessary to provide healthcare services. We spend a considerable amount of time and effort in educating healthcare professionals. We have many residents and clinical college students on-site throughout the year. We also have a job shadowing program for high school students in the area. We help educate these individuals in the hope that they will come back to the community to provide healthcare services. We provide funds for activities at area schools that provide a safe environment and education for our youth. We help sponsor the local blood drive through the American Red Cross. We donate funds to different organizations to improve the communitys health and safety.
Schedule H, Part III, Line 2	The amount reported on line two is taken directly from the general ledger. The amount that is written off to bad debt is the patients account balance when it is determined that the patient will not pay. Therefore, if the patient is self pay and has not paid any of the balance, then 100% of charges are written off. If the patient has commercial insurance and cannot pay the 20% coinsurance that is due after insurance has paid and the contracted discounts have been applied, then only the 20% coinsurance that is owed by the patient is written off to bad debt.
Schedule H, Part III, Line 3	The amount reported on line three is estimated based on past financial analysis performed by the Patient Accounting Manager and the Patient Financial Counselor. Historically, a review of the accounts written off to bad debt was done, taking into consideration the individuals financial situation. During the review, accounts that could have been written off as charity care if sufficient information was received were identified. As a result of the analysis, it was determined that $150,848 would possibly have qualified as charity care. There is a fine line between bad debt and charity care. There are those individuals who just will not pay, but there are a larger number of individuals who cannot pay, but do not want to fill out the paperwork for charity care or do not want to even ask for charity care. We have estimated that $150,848 of our bad debt expense should have been classified as charity care if the appropriate paperwork was received. These are the dollars that should be classified as community benefit.
Schedule H, Part III, Line 4	The accounts receivable footnote which discusses bad debt expense is on pages 6-7 of the Notes to Financial Statements.
Schedule H, Part III, Line 8	Total revenue received from Medicare and the Medicare allowable costs reported on Part III, lines 5 & 6 was taken directly from the 2015 Medicare Cost Report. In addition to the revenue received from Medicare and the Medicare allowable costs reported on the Medicare Cost Report, we also receive Medicare Part B payments (fee schedule) for certain lab, radiology, and physician services. These amounts are not included on the Medicare Cost Report. The revenue received for Medicare Part B services was $362,912 while the associated costs were $632,856 for a shortfall of ($269,944). The costs for the services reimbursed on a fee schedule methodology were calculated using the cost to charge ratio from the Medicare cost report for that department. The shortfall reported on Part III, line 7 of ($287,660) and the Medicare Part B shortfall of ($269,944) for a total shortfall of ($557,604) should be treated as a community benefit because these are costs over and above the amount that Medicare pays us. These services are integral to the community and would not be available to the community if they were not provided by our facility.
Schedule H, Part III, Line 9B	In our collection policy there is a section on financial assistance. It states: "Franciscan Care Services has a Financial Assistance program to assist patients that are financially burdened and unable to pay for their medical expenses. An assistance application must be completed and turned into the Financial Counselor. A copy of the most current tax information must accompany the application. A determination of approval or denial is made from this application and is based upon hospital established guidelines."
Needs Assessment	The health care needs of the communities we serve are assessed in many different ways. We work closely with Elkhorn Logan Valley Public Health Department who surveys the area population to ascertain health disparities, collaborate on health screenings, and determine areas of need. As our physicians and other health care workers see patients they discuss their current status and what else we can do for them. Also, our board members and employees who are in the public advise us as to what health care needs are in the community that we do not currently address. Many of our employees are involved in state and national organizations that keep us up-to-date on the current trends in health care that are brought back to our community. Through strategic planning with the physicians, the board of directors, and hospital leaders, we look at what the needs of the community are and how we can address them. All of these groups work together with Administration to continue to address the health care needs of the community.
Patient Education of Eligibility for Assistance	On the Conditions of Admission and Consent for Treatment form that is signed by each patient of the hospital, there is a financial agreement section that states "If you have limited insurance or do not have insurance, you may request to meet with our Financial Counselor to set up a payment plan or to determine if you are eligible for charity care." The collection policy is posted at the main entrance to the hospital and clinic and also at the emergency room entrance. Also, if the Financial Counselor contacts a patient regarding payment of a bill, a letter and a copy of the collection policy is sent to them which states that if they are unable to pay they may be eligible for the charitable care program that we offer. Lastly, on our website www.fcswp.org there is a section on Patient Financial Information. In this section there is information on our charity care policy and who to contact if the patient would like more information.
Community Information	Franciscan Care Services, Inc. is located in a rural area, predominantly agricultural based. The population of the five county service area is approximately 18,000 people. The median household income is approximately $48,000. The population is predominantly Caucasian, high-school educated, and geriatric in nature. There is a small population of Hispanic descent.
Promotion of Community Health	The board of directors is comprised of persons from the surrounding communities. The board members are diverse in background ranging from Sisters from our sponsor, a nurse, dentist, a school guidance counselor, bankers, and business owners, to farmers who are neither employees (except CEO), contractors, or family members. We hope the diverse backgrounds of our board members give us the insight we need to fulfill the needs of the community. Franciscan Care Services, Inc. has an open medical staff that includes one general surgeon, one orthopaedic surgeon, six family practice physicians, three physician assistants, and one nurse practitioner. There are also a number of specialists that come in from the nearby communities of Norfolk, Fremont, and Omaha to meet the health needs of the community. Specialists that see patients in our Outpatient Clinic include Audiology, Cardiology, ENT, Nephrology, Neurology, Obstetrics/Gynecology, Oncology, Ophthalmology, Pain, Podiatry, Pulmonology, Rheumatology, Urology, and Vascular. There are many different programs that we are able to offer due to surplus funds from operations. Our clinics provide disease management through the use of health coaches to help patients manage chronic health conditions such as diabetes, hypertension, COPD, clotting, and osteoporosis. This is a program that is good for our patients even though we receive little to no reimbursement for providing this service. We provide free sport screens to area athletes who have been injured at a practice or game. We offer reduced-cost screens and health education to businesses in our service area to reach out to those individuals who do not take the time to come to our facility to see us. We hosted a health fair to reach out to those who do not regularly schedule a clinic visit or annual lab tests.
Affiliated Health Care System	Franciscan Care Services, Inc. is a part of the Franciscan Sisters of Christian Charity Sponsored Ministries, a not-for-profit system of acute and long-term health care facilities and a liberal arts college located in Wisconsin, Nebraska and Ohio. Each organization within the Ministry is responsible for carrying out the healing and education mission of the Catholic Church according to the needs of their community.
State Filing of Community Benefit Report	The community benefit report is filed with the Nebraska Hospital Association. The report is also sent to our local mayor and our state and congressional representatives.

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Compensation Committee	Yes (X)	CompensationCommitteeInd
Independent Consultant	Yes (X)	IndependentConsultantInd
Compensation Survey	Yes (X)	CompensationSurveyInd
Board Or Committee Approval	Yes (X)	BoardOrCommitteeApprovalInd
Severance Payment	false	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	Yes (true)	SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm	false	EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org	Yes (true)	CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs	false	CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org	false	CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs	false	CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments	false	AnyNonFixedPaymentsInd
Initial Contract Exception	false	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (9 entries)

TitleTitleTxt	Base Compensation Filing OrgBaseCompensationFilingOrgAmt	Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt	Bonus Filing OrganizationBonusFilingOrganizationAmount	Bonus Related OrganizationsBonusRelatedOrganizationsAmt	Other Compensation Filing OrgOtherCompensationFilingOrgAmt	Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt	Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt	Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt	Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt	Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt	Total Compensation Filing OrgTotalCompensationFilingOrgAmt	Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt	Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
Jerry Wordekemper
CEO & Trustee	$121,643	$0	$16,842	$0	$9,032	$0	$7,175	$0	$26,477	$0	$181,169	$0	$0	$0
Ronald O Briggs
CEO & Trustee	$59,480	$0	$40,025	$0	$108,834	$0	$5,675	$0	$11,998	$0	$226,012	$0	$55,639	$0
Dennis Dinslage
V.P. Fiscal & Support Services	$135,157	$0	$24,869	$0	$6,063	$0	$9,085	$0	$27,275	$0	$202,449	$0	$0	$0
Terry Nelson
Rehab Manager	$192,485	$0	$200	$0	$774	$0	$16,500	$0	$27,590	$0	$237,549	$0	$0	$0
Kenneth Pitz MD
Physician	$463,229	$0	$200	$0	$27,774	$0	$12,500	$0	$30,452	$0	$534,155	$0	$0	$0
Michael Bittles MD
Physician	$404,617	$0	$200	$0	$10,545	$0	$13,000	$0	$30,501	$0	$458,863	$0	$0	$0
Scott Green MD
Physician	$287,712	$0	$112,617	$0	$9,774	$0	$14,500	$0	$30,452	$0	$455,055	$0	$0	$0
Brian Hass MD
Physician	$278,012	$0	$88,238	$0	$16,534	$0	$12,211	$0	$30,538	$0	$425,533	$0	$0	$0
Rhett Eckmann MD
Physician	$258,422	$0	$90,581	$0	$9,414	$0	$12,211	$0	$30,538	$0	$401,166	$0	$0	$0

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc

ExplanationExplanationTxt

SCHEDULE J, PART I, LINE 4b

QUESTIONS REGARDING COMPENSATION DURING 2015, FRANCISCAN CARE SERVICES INC. CONTRIBUTED FUNDS TO AN IRC SECTION 457(F) PLAN FOR THE FOLLOWING INDIVIDUALS: DR. BITTLES $13,000 DR. GREEN $ 4,000 DR. ECKMANN $ 4,321 DR. HASS $ 4,321 DR. PITZ $12,500 MR. NELSON $16,500 THE FOLLOWING INDIVIDUAL RECEIVED A PAYMENT FROM AN IRC SECTION 457(F) PLAN DURING THE YEAR: RON BRIGGS $55,639

SCHEDULE J, PART I, LINE 5a

QUESTIONS REGARDING COMPENSATION AT THE BEGINNING OF THE CALENDAR YEAR, THERE WAS A WRITTEN AGREEMENT ESTABLISHED REGARDING THE POTENTIAL AMOUNT OF SUPPLEMENTAL INCOME THAT CERTAIN PHYSICIANS MAY RECEIVE DURING THE YEAR BASED ON THEIR INDIVIDUAL PRODUCTIVITY. EACH OF THESE PHYSICIANS IS PAID A BASE SALARY AS AN EMPLOYED PHYSICIAN OF THE ORGANIZATION. IN ADDITION, THE PHYSICIAN MAY EARN ADDITIONAL COMPENSATION BASED ON A PRE-DETERMINED CALCULATED FORMULA AS STIPULATED IN THE WRITTEN AGREEMENT. THE FORMULA IN SUMMARY IS CALCULATED BY TAKING THE INDIVIDUAL'S PRODUCTIVITY REVENUE FOR THE CALENDAR YEAR LESS ANY CONTRACTUAL ADJUSTMENTS OR WRITE-OFFS AND THEN MULTIPLYING THAT NET AMOUNT BY A PRE-DETERMINED PERCENTAGE. IF THIS CALCULATED AMOUNT EXCEEDS THEIR BASE SALARY, THE PHYSICIAN IS PAID THE VARIANCE. DURING THE YEAR, DRS. GREEN, ECKMANN AND HASS RECEIVED A PAYMENT.

Schedule K IRS990ScheduleK

Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd

Issuer Name IssuerName

Field	Value	IRS element (for citing)
Business Name Line1	HOSPITAL AUTHORITY NO 1 OF CUMING COUNTY NE	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Bond Issuer EIN	470762878	BondIssuerEIN
Bond Issued	2010-07-27	BondIssuedDt
Issue Price	$12,000,000	IssuePriceAmt
Purpose	SEE SCHEDULE K, PART VI	PurposeDesc
Defeased	false	DefeasedInd
On Behalf Of Issuer	false	OnBehalfOfIssuerInd
Pool Financing	false	PoolFinancingInd

Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Retired	$1,439,739	RetiredAmt
Bond Defeased	$0	BondDefeasedAmt
Total Proceeds	$12,000,000	TotalProceedsAmt
In Reserve Fund	$0	InReserveFundAmt
Capitalized Interest	$0	CapitalizedInterestAmt
Refunding Escrow	$0	RefundingEscrowAmt
Issuance Costs From Proceeds	$0	IssuanceCostsFromProceedsAmt
Credit Enhancement	$0	CreditEnhancementAmt
Working Capital Expenditures	$0	WorkingCapitalExpendituresAmt
Capital Expenditures	$12,000,000	CapitalExpendituresAmt
Other Spent Proceeds	$0	OtherSpentProceedsAmt
Unspent	$0	UnspentAmt
Substantial Completion	2012	SubstantialCompletionYr
Current Refunding	false	CurrentRefundingInd
Advance Refunding	false	AdvanceRefundingInd
Final Allocation Made	Yes (true)	FinalAllocationMadeInd
Adequate Books And Rec Maint	Yes (true)	AdequateBooksAndRecMaintInd

Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Owning Bond Financed Property	false	OwningBondFinancedPropertyInd
Any Lease Arrangements	false	AnyLeaseArrangementsInd
Mgmt Contract Bond Fincd Prop	false	MgmtContractBondFincdPropInd
Any Research Agreements	false	AnyResearchAgreementsInd
Private Bus Use By Others	0.00000	PrivateBusUseByOthersPct
Private Bus Concerning UBI	0.00000	PrivateBusConcerningUBIPct
Total Private Business Use	0.00000	TotalPrivateBusinessUsePct
Bond Iss Meet Prvt Sec Pymt Test	false	BondIssMeetPrvtSecPymtTestInd
Change In Use Bond Financed Prop	false	ChangeInUseBondFinancedPropInd
Remedial Action Taken	false	RemedialActionTakenInd
Procs Nonqualified Bond Remdtd	Yes (true)	ProcsNonqualifiedBondRemdtdInd

Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Form8038 T Filed	false	Form8038TFiledInd
Exception To Rebate	Yes (true)	ExceptionToRebateInd
Variable Rate Issue	Yes (true)	VariableRateIssueInd
Hedge Identified In Bks And Rec	false	HedgeIdentifiedInBksAndRecInd

Hedge Provider Name HedgeProviderName

Field	Value	IRS element (for citing)
Business Name Line1	0	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Gross Proceeds Invested In GIC	false	GrossProceedsInvestedInGICInd

GIC Provider Name GICProviderName

Field	Value	IRS element (for citing)
Business Name Line1	0	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Gross Proceeds Invested	false	GrossProceedsInvestedInd
Written Proc To Monitor Reqs	Yes (true)	WrittenProcToMonitorReqsInd

Procedures Corrective Action ProceduresCorrectiveActionGrp

Field	Value	IRS element (for citing)
Bond Reference	A	BondReferenceCd
Procedures Corrective Action	Yes (true)	ProceduresCorrectiveActionInd

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	SCHEDULE K, PART 1, LINE A, COLUMN F:	FormAndLineReferenceDesc
Explanation	THE 2010 PROJECT CONSISTS OF A THREE STORY PATIENT BED ADDITION TO AND RELATED FIXED EQUIPMENT FOR THE EXISTING HOSPITAL FACILITY. THE 2010 PROJECT DOES NOT INCLUDE CERTAIN SPACE ON THE FIRST FLOOR NOT EXCEEDING 650 SQUARE FEET OF SPACE WITH ALLOCATED COSTS NOT IN EXCESS OF $250,000, WHICH IS TO BE UNFINISHED AND IS EXPECTED TO BE USED FOR STORAGE BUT WHICH MAY BE ALLOCATED TO AND SUBSEQUENTLY UTILIZED FOR PRIVATE OR UNRELATED BUSINESS ACTIVITY SUCH AS FOR A RETAIL PHARMACY.	ExplanationTxt

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (7 entries)

Relationship DescriptionRelationshipDescriptionTxt	TransactionTransactionAmt	TransactionTransactionDesc	Sharing Of RevenuesSharingOfRevenuesInd
BARBARA STEFFEN
SEE PART V	$27,094	EMPLOYMENT	false
DAN HAKEL
SEE PART V	$129,834	EMPLOYMENT	Yes (true)
BRENDA WISNIESKI
SEE PART V	$41,876	EMPLOYMENT	false
MARGUERITE KAUP
SEE PART V	$45,110	EMPLOYMENT	false
AGNES DINSLAGE
SEE PART V	$27,248	EMPLOYMENT	false
NANCY NELSON
SEE PART V	$36,957	EMPLOYMENT	false
CHERI DROESCHER
SEE PART V	$23,216	EMPLOYMENT	false

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	SCHEDULE L, PART IV	FormAndLineReferenceDesc
Explanation	BARBARA STEFFEN IS A FAMILY MEMBER OF JEROME STEFFEN, TRUSTEE DAN HAKEL IS A FAMILY MEMBER OF CHAD ORTMEIER, TRUSTEE BRENDA WISNIESKI IS A FAMILY MEMBER OF MARY JANATA, TRUSTEE MARGUERITE KAUP IS A FAMILY MEMBER OF GARY KAUP, TRUSTEE AGNES DINSLAGE IS A FAMILY MEMBER OF DENNIS DINSLAGE, OFFICER NANCY NELSON IS A FAMILY MEMBER OF TERRY NELSON, KEY EMPLOYEE CHERI DROESCHER IS A FAMILY MEMBER OF terry nelson, key employee	ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (8 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, PART IV, LINE 12a	Checklist of Required Schedules The organization's financial statements were audited on a separate basis but also consolidated at the organization's parent level. The organization uses the separate audited financial statements for tax return purposes.
FORM 990, PART VI, SECTION A, LINE 2	DAVE STEFFENSMEIER, TRUSTEE HAS A BUSINESS RELATIONSHIP WITH GARRY CLARK, TRUSTEE. DAVE IS THE CHAIRMAN OF THE CUMING COUNTY ECONOMICS DEVELOPMENT BOARD AND GARRY IS AN EMPLOYEE.
FORM 990, PART VI, SECTION A, LINE 6	THE ORGANIZATION IS A NOT-FOR-PROFIT CORPORATION WHOSE MEMBER IS FRANCISCAN SISTERS OF CHRISTIAN CHARITY SPONSORED MINISTRIES, INC.
FORM 990, PART VI, SECTION A, LINE 7A & 7B	THE FRANCISCAN SISTERS OF CHRISTIAN CHARITY SPONSORED MINISTRIES, INC. A WISCONSIN NON-STOCK, NOT FOR PROFIT CORPORATION HAS THE FOLLOWING RESERVED POWERS OVER FRANCISCAN CARE SERVICES INC.: A) APPROVAL OF THE PHILOSOPHY, MISSION AND VALUES STATEMENTS OF THE CORPORATION. B) AMENDMENT OF ARTICLES OF INCORPORATION AND BY-LAWS OF THE CORPORATION. C) APPOINTMENT AND REMOVAL OF MEMBERS TO THE BOARD OF DIRECTORS. D) APPROVAL OF THE CREATION AND DISSOLUTION OF THIS CORPORATION OR ANY SUBSIDIARY CORPORATIONS, AS WELL AS APPROVAL OF ANY MERGER, CONSOLIDATION, AFFILIATION, JOINT VENTURE OR OTHER FORM OF CORPORATE REORGANIZATION OF THIS CORPORATION OR ANY SUBSIDIARY OF WHICH THIS CORPORATION IS THE MEMBER OR CONTROLLING SHAREHOLDER. E) APPOINTMENT, EVALUATION AND DISCHARGE OF THE PRESIDENT OF THE CORPORATION. F) APPROVAL OF BORROWING IN EXCESS OF THE LIMIT ESTABLISHED BY THE MEMBER. G) APPROVAL OF PURCHASE, MORTGAGE OR SALE OF REAL ESTATE, OR LEASE OF REAL ESTATE, BY OR TO THE CORPORATION FOR LONGER THAN ONE YEAR. H) IMPLEMENTATION OF SPONSOR APPOINTMENT, SALARY NEGOTIATION, AND REASSIGNMENT PROCESSES FOR FRANCISCAN SISTER PERSONNEL WITHIN THIS CORPORATION. I) APPROVAL OF CAPITAL AND OPERATING BUDGETS. J) REQUIREMENT OF A CERTIFIED AUDIT OF CORPORATE FUNDS AT ANY TIME AND APPROVAL OF THE FISCAL AUDITOR OF THE CORPORATION ANNUALLY. K) APPROVAL OF ALL INSURANCE CARRIERS AND INSURANCE COVERAGE FOR THE CORPORATION. L) APPROVAL OF LONG-RANGE OR STRATEGIC PLANS OF THE CORPORATION.
FORM 990, PART VI, SECTION B, LINE 11B	FORM 990 IS REVIEWED PRIOR TO SUBMISSION BY THE MEMBER (FRANCISCAN SISTERS OF CHRISTIAN CHARITY SPONSORED MINISTRIES, INC.) AND THE FINANCE COMMITTEE OF THE FRANCISCAN CARE SERVICES, INC. BOARD OF DIRECTORS. A COPY OF FORM 990 WILL BE AVAILABLE FOR ALL BOARD MEMBERS TO REVIEW AT THEIR MONTHLY BOARD MEETING BEFORE THE 990 IS FILED. FORM 990 IS MADE AVAILABLE IN THE ADMINISTRATIVE OFFICE FOR ANY INDIVIDUAL REQUESTING TO INSPECT IT AS REQUIRED BY INTERNAL REVENUE CODE SECTION 6104.
FORM 990, PART VI, SECTION B, LINE 12C	THE CORPORATE COMPLIANCE OFFICER (CCO) AND SEVERAL MEMBERS OF THE CORPORATE COMPLIANCE COMMITTEE ATTEND BOARD, ADMINISTRATIVE, AND DEPARTMENT MANAGER MEETINGS. THE CCO ENSURES THAT ALL BOARD, MEDICAL STAFF, ADMINISTRATION STAFF, DEPARTMENT MANAGERS, AND INDIVIDUALS WHO HAVE PURCHASING AUTHORITY REVIEW THE CONFLICT OF INTEREST POLICY ANNUALLY AND DISCLOSE ANY CONFLICTS THAT MIGHT EXIST. EACH INDIVIDUAL IS ALSO ASKED TO IDENTIFY ANY FAMILY MEMBERS THAT ARE AN EMPLOYEE OF FCS, INC. OR EMPLOYED BY A BUSINESS WITH WHICH FCS CONDUCTS BUSINESS. ANY NEW CONFLICTS THAT ARISE DURING THE YEAR NEED TO BE REPORTED TO THE COMPLIANCE OFFICER IMMEDIATELY. IF A CONFLICT EXISTS AT THE BOARD LEVEL, THE PERSON OR THE CCO OR COMMITTEE MEMBER IDENTIFIES THAT THE CONFLICT EXISTS AND THEN THE BOARD DETERMINES IF THE PERSON CAN TAKE PART IN THE DELIBERATIONS OR NEEDS TO LEAVE THE ROOM. THE PERSON WOULD NOT BE ABLE TO VOTE AND IT IS IDENTIFIED IN THE MINUTES OF THE MEETING. AT THE ADMINISTRATIVE LEVEL, THE STAFF MEMBER IDENTIFIES THE CONFLICT AND THE ADMINISTRATIVE TEAM DETERMINES IF THE PERSON CAN TAKE PART IN THE DISCUSSION OR NEEDS TO LEAVE THE ROOM. THIS IS ALSO THE POLICY AT THE MEDICAL STAFF AND MANAGER MEETINGS.
FORM 990, PART VI, SECTION B, LINE 15A & 15B	FRANCISCAN CARE SERVICES, INC. STRIVES TO PROVIDE A FAIR AND COMPETITIVE COMPENSATION PACKAGE FOR ITS EXECUTIVE. THIS PACKAGE SHALL INCLUDE, BUT IS NOT LIMITED TO SALARY, INCENTIVE BONUS, LIFE INSURANCE, HEALTH BENEFITS, AND A MATCHING DEFINED CONTRIBUTION TO A 403(B) RETIREMENT PLAN. THE SALARY RANGE AND TOTAL COMPENSATIONS SHALL BE BASED UPON SURVEYS OF THE GEOGRAPHIC WEST NORTH CENTRAL STATES AVERAGE FOR THE POSITION AS REPORTED BY AN INDEPENDENT EXECUTIVE COMPENSATION MARKET ANALYSIS FOR LIKED SIZED ORGANIZATIONS AND THE EXECUTIVE COMPENSATION SURVEY FOR NEBRASKA HOSPITALS PROVIDED BY THE NEBRASKA HOSPITAL ASSOCIATION. BONUSES ARE GIVEN BASED UPON ACHIEVEMENT OF STRATEGIC GOALS AGREED UPON BY THE FRANCISCAN CARE SERVICES BOARD OF DIRECTORS AND THE PRESIDENT OF THE FRANCISCAN SISTERS OF CHRISTIAN CHARITY SPONSORED MINISTRIES, INC. THESE BONUSES ARE BASED UPON A PERCENTAGE OF SALARY AND ARE NOT TO EXCEED 25%. THE PRESIDENT/CEO'S COMPENSATION IS SET BY THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS AND THE SPONSORED MINISTRIES PRESIDENT AFTER A PERFORMANCE APPRAISAL CONDUCTED BY THE EXECUTIVE COMMITTEE OF THE FCS BOARD (SERVING AS THE COMPENSATION COMMITTEE) AND THE PRESIDENT OF FRANCISCAN SISTERS OF CHRISTIAN CHARITY SPONSORED MINISTRIES, INC. ALL MEMBERS OF THE BOARD PROVIDE THEIR INPUT THROUGH A WRITTEN APPRAISAL PRESENTED TO THE COMPENSATION COMMITTEE. MINUTES OF THE MEETING ARE KEPT BY THE SPONSORED MINISTRIES PRESIDENT. ALL OTHER EXECUTIVES ARE REVIEWED BY THE FRANCISCAN CARE SERVICES, INC. PRESIDENT/CEO, WHO SETS THEIR COMPENSATION BASED UPON THE ABOVE SURVEYS AND PRINCIPLES.
FORM 990, PART VI, SECTION C, LINE 19	NO DOCUMENTS AVAILABLE TO THE PUBLIC.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (8 entries)

Address Line1USAddress/AddressLine1Txt	CityUSAddress/CityNm	State AbbreviationUSAddress/StateAbbreviationCd	ZIPUSAddress/ZIPCd	EINEIN	Primary ActivitiesPrimaryActivitiesTxt	Legal Domicile StateLegalDomicileStateCd	Exempt Code SectionExemptCodeSectionTxt	Public Charity StatusPublicCharityStatusTxt	Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt	Controlled OrganizationControlledOrganizationInd
HOLY FAMILY CONVENT FRANCISCAN SISTERS
2409 SOUTH ALVERNO ROAD	MANITOWOC	WI	54220	390808523	RELIGION	WI	501(C)(3)	LINE 1	NA	false
FRANCISCAN SISTERS OF CHRISTIAN CHARITY
1415 SOUTH RAPIDS ROAD	MANITOWOC	WI	54220	391530622	EDU/HLTHCARE	WI	501(C)(3)	LINE 1	SEE LINE 1	false
ST FRANCIS MEMORIAL HOSPITAL FOUNDATION
430 N MONITOR ST	WEST POINT	NE	68788	470629079	FUNDRAISING	NE	501(C)(3)	11A TYPE I	NA	false
ST JOSEPHS RETIREMENT COMMUNITY FDN
PO BOX 65	WEST POINT	NE	68788	470790644	FUNDRAISING	NE	501(C)(3)	11A TYPE I	NA	false
HOLY FAMILY MEMORIAL INC
2300 WESTERN AVE PO BOX 1450	MANITOWOC	WI	54221	390806395	HEALTHCARE	WI	501(C)(3)	Line 3	SEE LINE 2	false
ST PAUL ELDER SERVICES INC
316 EAST 14TH STREET	KAUKAUNA	WI	54130	391029149	ELDER CARE	WI	501(C)(3)	LINE 9	SEE LINE 2	false
GOOD SAMARITAN MEDICAL CENTER
800 FOREST AVENUE	ZANESVILLE	OH	43701	314379479	HOLDING CO.	OH	501(C)(3)	11A TYPE I	SEE LINE 2	false
SILVER LAKE COLLEGE OF HOLY FAMILY INC
2406 SOUTH ALVERNO ROAD	MANITOWOC	WI	54220	390980974	HIGHER EDUCAT	WI	501(C)(3)	LINE 2	SEE LINE 2	false

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp

Related Organization Name RelatedOrganizationName

Field	Value	IRS element (for citing)
Business Name Line1	HOLY FAMILY HEALTH SERVICES	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	3310 CALUMET AVENUE	AddressLine1Txt
City	MANITOWOC	CityNm
State Abbreviation	WI	StateAbbreviationCd
ZIP	54220	ZIPCd

Field	Value	IRS element (for citing)
EIN	391572253	EIN
Primary Activities	PHARMACY	PrimaryActivitiesTxt
Legal Domicile State	WI	LegalDomicileStateCd

Direct Controlling Entity Name DirectControllingEntityName

Field	Value	IRS element (for citing)
Business Name Line1	See Pt II Ln 5	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Entity Type	C CORP	EntityTypeTxt
Controlled Organization	false	ControlledOrganizationInd

Field	Value	IRS element (for citing)
Receipt Of Int Annts Rnts Rylts	false	ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org	false	GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org	Yes (true)	GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org	Yes (true)	LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org	Yes (true)	LoansOrGuaranteesFromOthOrgInd
Div Related Organization	false	DivRelatedOrganizationInd
Asset Sale To Other Org	false	AssetSaleToOtherOrgInd
Asset Purchase From Other Org	false	AssetPurchaseFromOtherOrgInd
Asset Exchange	false	AssetExchangeInd
Rental Of Facilities To Oth Org	Yes (true)	RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org	false	RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org	false	PerformOfServicesForOthOrgInd
Perform Of Services By Other Org	Yes (true)	PerformOfServicesByOtherOrgInd
Sharing Of Facilities	false	SharingOfFacilitiesInd
Paid Employees Sharing	Yes (true)	PaidEmployeesSharingInd
Reimbursement Paid To Other Org	Yes (true)	ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org	Yes (true)	ReimbursementPaidByOtherOrgInd
Transfer To Other Org	false	TransferToOtherOrgInd
Transfer From Other Org	Yes (true)	TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp

Other Organization Name OtherOrganizationName

Field	Value	IRS element (for citing)
Business Name Line1	ALL TRANSACTIONS WERE BETWEEN 501(c)(3) ORGS	BusinessNameLine1Txt